Center looks for ways to help those with TBI

“They come in and we ask them three questions,” said Navy Capt. Thomas C. Armel, the director of the MSCRC. “One: How did you get here? Two: What can we do for you? And three: Is there anything we can help you or your spouse with?”

Don Bryan/The Daily News

By THOMAS BRENNAN Daily News Staff

Published: Sunday, April 7, 2013 at 03:52 PM.

Traumatic Brain Injuries are the signature wounds of Iraq and Afghanistan. Service members aboard Camp Lejeune can turn to the Marine and Sailor Concussion Recovery Center for comprehensive treatment in their 16-week program.

“They come in and we ask them three questions,” said Navy Capt. Thomas C. Armel, the director of the MSCRC. “One: How did you get here? Two: What can we do for you? And three: Is there anything we can help you or your spouse with?”

A traumatic brain injury is a blow or jolt to the head that disrupts the normal function of the brain, according to the Defense and Veterans Brain Injury Center. TBI is determined at the time of the injury and may be classified as mild, moderate or severe. The MSCRC offers neurological, speech-language therapy, occupational and vestibular therapies, psychological and neuro-psychological support as well as nurse case management.

More than 253,000 concussions have occurred in troops Afghanistan and Iraq since 2001, according to the Congressional Research Service.

In March the MSCRC’s 52-person staff cared for 462 patients during 2,500 appointments. On average 70 new cases are added every month with 70 percent of all patients returning to full duty and continuing their military careers, according to Armel.

“We ask them about their headaches, their sleep and about their day-to-day living — all those types of questions,” Armel said. “We get consults from all across the base. ...The consults come from green side and blue side. They’re coming from our family practice doctors, MARSOC, division — all over. We accept just about everybody that comes with a consult.”

Traumatic Brain Injuries are the signature wounds of Iraq and Afghanistan. Service members aboard Camp Lejeune can turn to the Marine and Sailor Concussion Recovery Center for comprehensive treatment in their 16-week program.

“They come in and we ask them three questions,” said Navy Capt. Thomas C. Armel, the director of the MSCRC. “One: How did you get here? Two: What can we do for you? And three: Is there anything we can help you or your spouse with?”

A traumatic brain injury is a blow or jolt to the head that disrupts the normal function of the brain, according to the Defense and Veterans Brain Injury Center. TBI is determined at the time of the injury and may be classified as mild, moderate or severe. The MSCRC offers neurological, speech-language therapy, occupational and vestibular therapies, psychological and neuro-psychological support as well as nurse case management.

More than 253,000 concussions have occurred in troops Afghanistan and Iraq since 2001, according to the Congressional Research Service.

In March the MSCRC’s 52-person staff cared for 462 patients during 2,500 appointments. On average 70 new cases are added every month with 70 percent of all patients returning to full duty and continuing their military careers, according to Armel.

“We ask them about their headaches, their sleep and about their day-to-day living — all those types of questions,” Armel said. “We get consults from all across the base. ...The consults come from green side and blue side. They’re coming from our family practice doctors, MARSOC, division — all over. We accept just about everybody that comes with a consult.”

The ideal patient would be someone who has had a concussion within the last year because the MSCRC has seen that they are the ones who can be affected the greatest by therapy, according to Armel, who also said that they take patients who have concussions from years prior as well.

With a whole body approach in mind, the MSCRC forms an interdisciplinary team of all the providers caring for a patient and they discuss their findings, according to Armel. It is during these meetings that they form a treatment plan for the Marine or sailor and discuss the likelihood of the service member returning to their career.

Michelle Geers, 28, of Mobile, Ala., is one of a handful of speech-language pathologists with the MSCRC who participate in those meetings.

“We evaluate cognitive linguistic aspects,” Geers said. “A lot of them have short term memory loss after concussions. Many have language problems that may include word finding problems — the word is on the tip of their tongue and they cant think of it. ...We evaluate those different areas. In the evaluations we have them stick to learning different words and stories.”

Many Marines and sailors report memory problems, which is another focus of speech-language treatment, according to Geers.

“For memory we do a lot of education,” Geers said. “We teach a lot of compensatory strategies. A lot of guys tell us they have problems remembering where they parked their car at Walmart or remembering where they put their keys or wallet. Strategies we might teach them are to put a basket by their front door where they put everything into it — we call it a shrine.”

As a service member attends occupational therapy, therapists such as Scott Cormier, 37, of Milford, Maine, focus on the patient’s ability to do things like stay focused, plan, participate, organize thoughts, complete tasks, cope with changes in a routine and many other behaviors.

“We see mild concussions so we overlap in some areas (with speech-language),” Cormier said. “We are looking at the activities that they do in daily life and how they are being disrupted. We fix that.”

One of the main clinical complaints of troops returning with mild traumatic brain injuries are constant headaches, and the MSCRC has a neurologist who aids in providing relief to patients.

Capt. Thomas Johnson, a board certified neurologist with the MSCRC, said the goalis to return each individual to the highest level of functioning possible.

“In order to do that we need to try and manage them in order for them to reach their goals,” he explained.

Johnson said the clinic often uses holistic approaches and looks at the patient as more than just a symptom or a collection of symptoms. Many of the treatments available to Marines and sailors for concussions include nerve blocks, Botox injections in the scalp and acupuncture.

“We don’t look at it from the typical, ‘My head hurts, give me a pill.’ We try to look at all aspects and all dimensions,” Johnson said. “...We’ve found acupuncture to be very successful. We’ve found a lot of service members respond to acupuncture. ...The patient truly gets a standard evaluation that is exhaustive.”